Millions of people around the world have suffered from various degrees of strokes. Stroke remains a leading cause of long term disability in the United States. Approximately 40% of stroke survivors require at least some assistance with ADL (activities of daily living), and at least half of the stroke survivors require at least some assistance. Many of the stroke survivors experience long term effects such as partial paralysis due to permanent neurological deficiencies.
Consequently, stroke survivors are often deconditioned and predisposed to a sedentary lifestyle that limits performance of ADL, and may contribute to the risk of suffering from cardiovascular disease. As with heart disease physical inactivity serves as an emerging risk factor for recurrent stroke. It has been proven that daily caloric expenditure by performing aerobic exercise strongly reduces the risk of suffering from a recurrent stroke. More than 70% of stroke patients suffer from neurological impairment that requires a long term rehabilitation program. The main rehabilitation goals for stroke patients are:
1. Preventing complications from prolonged inactivity;
2. Increasing aerobic fitness;
3. Decreasing recurrent stroke and cardiovascular events.
These goals can be achieved only by using a long term rehabilitation program. The recommended weekly expenditure of energy is approximately 4200 KJ. The recommended frequency of training is between 3 to 7 times a week with a duration of 30 to 60 minutes of continuous or accumulated exercise.
In many cases the stroke survivor fails to perform a long term exercise program to the full extent due to the complexity of getting to a rehabilitation center in the survivors incapacitated state. Such programs are not accessible to most patients due to social and economic reasons. The solution to this problem would require performing a long term rehabilitation program in the patient's home environment without the aid of trained medical personnel.
A home training program requires two important conditions:
1. A high safety level for the patient while performing the exercise;
2. An exercise device located at the home of the patient.
Generally exercise is a normal human function that can be undertaken with a high level of safety by most people including stroke survivors. However stroke survivors are at a higher level of risk when performing exercise. One problem is related to balance wherein stroke survivors tend to be more prone to suffer from falling over and getting hurt. A second problem is sudden cardiac death which may occur if the person is overloaded while performing exercise. Cardiac disease has been reported to occur in up to 75% of stroke survivors, either having occurred before suffering from the stroke or having developed afterwards. Therefore an exercise program for stroke survivors needs to be able to prevent falling over and to prevent work overloading the person's cardiac system. Each person needs an individually designed program that is monitored to prevent work overload.
The exercise device needs to allow the user to perform exercise at home according to a specific program designed for the user. Preferably it should be customizable, portable and non expensive. Additionally, it should enable exploitation of the person's large muscles to maximize effectiveness of the training program and enable people that suffer from various neurological deficits or anatomic limitations to be able to benefit from the exercise device with minimal risk.